In 2013, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a new clinical practice guideline for the treatment of blood cholesterol in patients at high risk for atherosclerotic cardiovascular disease (ASCVD). The guideline was prepared by a panel of experts based on an analysis of the results of randomized controlled trials. The guidelines use the highest-quality scientific evidence to focus the treatment of blood cholesterol to those who are likely to benefit most. A Focus on Statins According to Neil J. Stone, MD, who served as chair of the expert panel that wrote the guideline, the ACC/AHA guidelines represent a departure from previous recommendations. “The guidelines don’t recommend specific target levels of LDL cholesterol,” he says. “Instead, they focus on defining patient groups for whom LDL lowering with statins has been proven to be most beneficial.” The panel recommended use of statins after a detailed review of other cholesterol-lowering drugs. “Most statins are generics and have been shown to provide the greatest benefit while having low rates of safety issues when taken as prescribed,” Dr. Stone says. The guidelines note, however, that there is a role for other cholesterol-lowering drugs in selected patients who suffer side effects from statins. The guidelines identified four major groups of patients for whom statins have the greatest likelihood of preventing stroke and heart attacks. Moderate- or high-intensity statin therapy is recommended for patients. 1. With clinical ASCVD. 2. With primary elevations of LDL cholesterol of 190 mg/dL or higher. 3. Aged 40 to 75 with diabetes and LDL cholesterol levels between 70 and 189 mg/dL without clinical ASCVD....